[Digestive hemorrhage units. A national survey].

The results of a national survey carried out on two hundred and five Spanish hospitals, on the treatment of upper gastrointestinal bleeding (UGIB) and special units for gastrointestinal haemorrhages, are reported in this paper. Questionnaires were sent to the chief of every Surgery, Gastroenterology and Internal Medicine Service. We received three hundred and twenty six answered questionnaires from 179 hospitals out of a total number of 582 mailed all over Spain. The Gastroenterology Units manage the UGIB in most hospitals, and in 45% of these, a protocol elaborated by gastroenterologists and surgeons is followed. In general, 94% of answers agree in the convenience or even need of Gastrointestinal Haemorrhage Units. However, when asked about this point in the setting of their own hospital, this figure comes down to 83%. On the other hand, only 46% consider the units to be warranted from the medical care and economical points of view. Most doctors think that to assess the yield of these units, medical care, economical and research criteria should be kept in mind. The general opinion is that should they exist in a given hospital, they should work as intermediate care units (87%), and be dependent of both Gastroenterology and Surgery units (71%). Currently, there are in Spain ten Gastrointestinal Haemorrhage Units, with a mean number of 6 beds, located in large hospitals, most of them run by the Gastroenterology Service. All of them are involved in some research project. In these units, overall mortality rates for UGIB, and mortality rate in bleeding peptic ulcers range close to 7% and 3%, respectively.